2024-03-20 19:57:00
In a shopping street in central Osaka (Japan), March 15, 2024. RICHARD A. BROOKS / AFP
Japan is concerned about the explosion in cases of very serious streptococcal toxic shock syndrome (SSTS) due to group A streptococci (GAS or pyogenic streptococci). The National Institute of Contagious Diseases (NIID) counted 422 cases between January 1 and March 17. There were 941 in 2023. Twenty-seven of the forty-seven departments of the Archipelago are on red alert for this infection, the mortality rate of which exceeds 30%.
The situation is all the more serious as the authorities discovered in the summer of 2023 – and for the first time in Japan – a GAS of the M1UK lineage (British strain, the most common in Europe), more virulent and more transmissible .
Sometimes nicknamed “flesh-eating,” the bacteria – which many people carry without knowing it or falling ill – can cause infection of the subcutaneous tissues and necrotizing fasciitis, named for the fascia, the tissue that covers the muscles. Then, multiple organ failure occurs, including acute renal failure, acute respiratory distress syndrome and disseminated intravascular coagulation, a coagulation abnormality that can result in hemorrhages and thromboses. All at a fast pace. “A third of people who develop the disease can die within forty-eight hours”explains Ken Kikuchi, an infectious disease specialist at Tokyo Women’s Medical University, who says “very concerned” by the increase observed in 2024.
Serious consequences
Patients who do not die can suffer serious consequences. In a January 22 report, TV Asahi cited the case of a man who felt pain in his leg after a day of playing basketball. SHis leg swelled, turning purplish in places, and his temperature reached 40°C. He saw a doctor, who did not do blood tests but prescribed antibiotics and fever medication. “If I was in too much pain, I also had painkillers”, he testified. A week later, he was rushed to hospital after fainting: “Sepsis due to “flesh-eating bacteria” was diagnosed. » He had to have his leg amputated and survived after a stay in intensive care.
Transmission of SGA would occur by droplets. But, underline the American Centers for Disease Control and Prevention, “For almost half of people with SCTS, experts don’t know how the bacteria got into the body. Sometimes it enters through openings, such as a wound or surgical wound. It can also enter through the mucous membranes, inside the nose and throat.”
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